Exam 2 Flashcards

1
Q

Shoulder muscles that originate on the vertebral column/skull

A
Trapezius
Rhomboid Major
Rhomboid MInor
Levator Scapula
Latissimus Dorsi
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2
Q

Trapezius

Origin

A

External occipital protuberance
Superior nuchal line
Ligamentous nuchae
Spines of the thoracic vertebrae (C7-T12)

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3
Q

Trapezius

Insertion

A

Clavicle

Acromion process and spine of scapula

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4
Q

Trapezius

Actions

A

Stabilizes scapula
Upper portion: elevates scapula
Middle and lower portions: adduct and depress scapula

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5
Q

Trapezius

nerve supply

A

Motor: spinal accessory nerve (CN XI)
Sensory: C3, C4

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6
Q

Trapezius Palsy

A

Deepening of the shoulder on the affected side

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7
Q

Whiplash injury

A

Beyond tensile strength

-trapezius

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8
Q

Rhomboid Major

Origin

A

Spines/upper thoracic vertebrae

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9
Q

Rhomboid Major

Insertion

A

Vertebral border of scapula

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10
Q

Rhomboid minor

Origin

A

Spines/ lower cervical and first thoracic vertebrae

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11
Q

Rhomboid minor

Insertion

A

Vertebral border/scapula

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12
Q

Levator scapula

Origin

A

Transverse processes/upper cervical vertebrae

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13
Q

Levator Scapula

Insertion

A

Superior angle/scapula

Proximal medial border/scapula

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14
Q

Actions of Rhomboids and Levator Scapula

A

Elevates scapula
Adducts scapula
Stabilize scapula

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15
Q

Innervation of Rhomboids and Levator Scapula

A

Dorsal Scapula Nerve (C5)

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16
Q

Damage to Dorsal Scapular Nerve (C5)

A

Difficulty in complete adducting scapula

Scapula further from midline (on affected side)

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17
Q

Latissimus Dorsi

Origin

A

Spines/lower thoracic and lumbar vertebrae
Thoracodorsal fascia
Crest/ilium
Lower ribs

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18
Q

Latissimus Dorsi

Insertion

A

Intertubercular groove (lesser tubercle)/ humerus

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19
Q

Latissimus Dorsi

Actions

A

Extends humerus
Adducts humerus
Medially rotates humerus
Involved with forced expiration

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20
Q

Latissimus Dorsi

Nerve Supply

A

Thoracodorsal (C6, C7, C8)

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21
Q

Weakness or damage to latissimus dorsi

A

Forward displacement of humerus at shoulder joint

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22
Q

Lumbar triangle

A

Latissimus dorsi
Crest of ilium
External oblique muscle

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23
Q

Clinical significance of lumbar triangle

A

Hernia of posterior abdominal wall

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24
Q

Triangle of auscultation

A

Latissimus dorsi, trapezius, vertebral border of scapula

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25
Q

Clinical significance of triangle of auscultation

A

Easily hear lungs sounds

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26
Q

Serratus anterior

Origin

A

Upper 8 or 9 ribs

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27
Q

Serratus anterior

Insertion

A

Vertebral border/scapula

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28
Q

Serratus anterior

Actions

A

Abducts scapula
Stabilizes scapula
Involved with forced inspiration (only when humerus abducted)

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29
Q

Serratus anterior

Nerve

A

Long thoracic (C5, C6, C7)

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30
Q

Long thoracic nerve palsy

A

Aka winged scapula

Serratus anterior is weakened due to damage to nerve

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31
Q

Scapular Muscles

A
Deltoid 
Supraspinatus
Infraspinatus
Subscapularis
Teres Major 
Teres minor
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32
Q

Rotator Cuff Muscles

A

Supraspinatus
Infraspinatus
Subscapularis
Teres minor

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33
Q

Criteria for Rotator Cuff Muscles

A

Tendon of insertion must contribute to forming cuff around proximal part of humerus
Participate in either lateral or medial rotation of humerus

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34
Q

Deltoid

Origin

A

Clavicle
Acromion process
Spine of scapula

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35
Q

Deltoid

Insertion

A

Deltoid tuberosity/ humerus

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36
Q

Deltoid

Actions

A

Anterior- flexes and medially rotates humerus
Middle- abducts humerus
Posterior- extends and laterally rotates humerus

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37
Q

Deltoid

Nerve supply

A

Axillary nerve (C5, C6)

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38
Q

Atrophy of deltoid

A

Aka Crutch Paralysis

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39
Q

Supraspinatus

Origin

A

Supraspinatus fossa/ scapula

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40
Q

Supraspinatus

Insertion

A

Greater tuberosity/ humerus

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41
Q

Supraspinatus

Actions

A

Initiates abduction of humerus
Laterally rotates humerus
Stabilizes shoulder joint

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42
Q

Supraspinatus

Nerve

A

Suprascapular (C5, C6)

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43
Q

Tendon of insertion for supraspinatus is separated from acromion process by

A

Subacromial and subdeltoid bursa

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44
Q

Rotator Cuff Tendonitis

A

Irritation and inflammation of supraspinatus tendon

Aka shoulder impingement Syndrome

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45
Q

Causes of rotator cuff tendonitis

A
Genetic
Weakness around rotator cuff
Excess stress and repetition
Trauma/injury
Calcium deposits
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46
Q

Rotator cuff Tears

A

Tendon usually ruptures at or near insertion

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47
Q

Drop test

A

To evaluate Rotator Cuff Tears

Lower fully abducted limb slowly and limb will drop suddenly to patient’s side in uncontrolled manner if tendon torn

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48
Q

Bursitis in Rotator Cuff

A

Inflammation of bursa that separates tendon from acromion process (subdeltoid or subacromial)

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49
Q

Infraspinatus

Origin

A

Infraspinatus fossa/ scapula

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50
Q

Infraspinatus

Insertion

A

Greater tuberosity/ humerus

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51
Q

Infraspinatus

Actions

A

Laterally rotates humerus

Stabilizes shoulder joint

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52
Q

Infraspinatus

Nerve

A

Suprascapular (C5, C6)

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53
Q

Subscapularis

Origin

A

Subscapular fossa/ scapula

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54
Q

Subscapularis

Insertion

A

Lesser tuberosity/ humerus

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55
Q

Subscapularis

Actions

A

Medially rotates humerus

Stabilizes shoulder joint

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56
Q

Subscapularis

Nerve

A

Upper and lower subscapular nerves (C5, C6)

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57
Q

Teres Minor

Origin

A

Axillary border/ scapula

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58
Q

Teres minor

Insertion

A

Greater tuberosity/ humerus

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59
Q

Teres minor

Actions

A

Laterally rotates humerus

Stabilizes shoulder joint

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60
Q

Teres minor

Nerve

A

Axillary (C5, C6)

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61
Q

Teres major

Origin

A

Inferior angle/scapula

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62
Q

Teres major

Insertion

A

Intertubercular groove/ humerus

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63
Q

Teres major

Actions

A

Adducts and medially rotates humerus

Stabilizes shoulder joint

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64
Q

Teres major

Nerve

A

Lower subscapular (C6)

65
Q

Quadrilateral space

A

More lateral of two spaces

66
Q

Quadrilateral space contains

A

Axillary nerve

Humeral circumflex blood vessels

67
Q

Triangular space

A

More medial of spaces between teres major and teres minor

68
Q

Triangular space contains

A

Circumflex scapular branch of the subscapular artery

69
Q

Ligaments can be classified as either

A

Extrinsic (extracapsular)

Intrinsic (intracapsular)

70
Q

Extrinsic ligaments found

A

Superficial to capsular ligament

71
Q

Intrinsic ligaments found

A

Deep to capsular ligament

72
Q

Sternoclavicular joint

Articulation

A

Sternal end of clavicle
Clavicular and costal notches of sternum (manubrium)
Medial end of first rib

73
Q

Articular disc of SC joint

A

Piece of cartilage found in middle of joint cavity

Divides joint cavity in two

74
Q

Function of articular disc

A
  1. Prevent clavicle from being displaced at its articulation w/ sternum
  2. Acts as shock absorber for forces transmitted along clavicle
75
Q

SC joint classified as

A

Plane gliding joint

76
Q

Nerve supply to SC joint

A

Supraclavicular nerve

Nerve to subclavius

77
Q

Sternoclavicular joint

A

Upper limb articulates with axial skeleton

78
Q

Most stable joint of the upper extremity

A

Sternoclavicular joint

79
Q

Ligaments associated with SC joint

A

Anterior/ posterior sternoclavicular
Interclavicular
Costoclavicular

80
Q

Anterior and Posterior Sternoclavicular

A

Reinforce capsular ligament
Extrinsic- acts like wall
Prevent excessive protraction/retraction

81
Q

Interclavicular

A

Attached to sternal ends of both clavicles
Extrinsic- acts like rope
Prevents displacement of clavicle when carrying heavy object

82
Q

Costoclavicular

A

Strong ligament attached to costal impression of clavicle and first rib
Extrinsic- acts like rope
Reinforce capsular ligament- limits elevation at medial end of clavicle

83
Q

Dislocation of SC joint

A

Rare
If occurs, due to direct trauma to anterior aspect of sternal end of clavicle
May be life threatening due to damage/compression of trachea or blood vessels in neck

84
Q

Acromioclavicular Joint

Articulation

A

Acromion process of scapula

Lateral (acromial) end of clavicle

85
Q

Joint classification of acromioclavicular joint

A

Plane gliding

86
Q

Nerve supply of acromioclavicular joint

A

Dorsal scapular
Suprascapular
Axillary nerve

87
Q

Superior and inferior acromioclavicular ligament

A

Extrinsic and acts like rope

Prevents clavicle from losing contact with acromion process

88
Q

Coraclavicular ligament

A

Extrinsic; acts like rope

Divided into conoid and trapezoid portions

Connects clavicle with coracoid process/scapula

89
Q

Dislocation of acromioclavicular joint

Shoulder separation

A

Occurs due to severe blow to shoulder (shoulder pointer)

Subclavian artery may be compromised

90
Q

Shoulder/ Glenohumeral Joint

A

Universal joint

Relatively unstable

91
Q

Damage to radial nerve

A

Wrist drop

92
Q

Radial artery of forearm

A

Lateral terminal branch of brachial artery

93
Q

Branches of radial artery

A

Recurrent

Superficial and deep palmer

94
Q

Recurrent radial artery branch

A

Runs proximally to brachial profundus

Collateral circulation around lateral aspect of elbow

95
Q

Superficial and deep palmer artery joint with _____ artery to form ____ and ____ of the hand

A

Ulnar
Superficial
Deep palmar arches

96
Q

Ulnar artery of the forearm

A

Medial branch of brachial artery

Deep to flexor Carpi Ulnaris

97
Q

Branches of ulnar artery

A

Anterior and Posterior recurrent
Common interosseous
Superficial and deep palmar

98
Q

Anterior and Posterior recurrent ulnar artery

A

Joins ulnar collateral of brachial

Forms collateral circulation of medial aspect of elbow

99
Q

Common interosseous

A

Proximal part of artery

Divides into anterior and posterior interosseous artery

100
Q

Superficial and deep palmar artery

A

Helps form superficial and deep palmar arches

101
Q

Distal Radio-Ulnar Joint

A

Pivot joint
Nerve supply: radial
Articulation: head of ulna and ulnar notch of radius

102
Q

Ligaments of distal radio-ulnar joint

A

Capsular ligament
Anterior and posterior transverse ligament
Articular disc
Interosseous membrane

103
Q

Anterior and posterior ligament (DRUJ)

A

Unite distal ends of radius and ulna
Prevents supination
Extrinsic rope

104
Q

Articular disc of DRUJ

A

Fibrocartilage that attaches ulnar notes and styloid process of ulna
Unites distal end of two bones
Chief uniting structure

105
Q

Interosseous membrane of DRUJ

Function

A

Strength and stability between radius and ulna
Limit supination
Increase surface attachment of muscles in both anterior and posterior forearm

106
Q

Supination is ___ ______ than pronation

A

More powerful

107
Q

Radiocarpal joint

A

Condyloid
Articulation: distal end of radius, articular disc, scaphoid, lunate, triquetral
Nerve supply: radial, ulnar, median

108
Q

Ligaments of radiocarpal joint

A

Capsular
Dorsal and palmar radiocarpal
Palmar ulnocarpal
Ulnar and radial collaterals

109
Q

Dorsal and palmar radiocarpal ligaments

A

Extrinsic and act like rope

Attaches ulna to scaphoid and lunate

110
Q

Palmar ulnocarpal

A

Extrinsic rope

Attaches ulna to scaphoid and lunate

111
Q

Ulnar and radial collaterals

A

Extrinsic rope

Attach styloid process of ulna to radius to carpal bones

112
Q

___ and ____ do not occur at wrist joint

A

Medial and lateral rotation

113
Q

____ is chief tactile organ

A

Hand

114
Q

Structures not held down by flexor retinaculum

A

Tendon of insertion of palmaris longus

Cutaneous branches of ulnar nerve

115
Q

Osseofibrous carpal tunnel

A

Median nerve and long flexor tendons to digits pass through

116
Q

Carpal tunnel syndrome aka

A

Distal median nerve neuropathy

117
Q

Carpal tunnel syndrome is compression of

A

Median nerve

118
Q

Causes of carpal tunnel syndrome

A
Edema
Smith’s fracture
Tumors 
Oral contraceptives
Repetitive flexion and extension at wrist
Misalignment of bones
119
Q

Symptoms of carpal tunnel syndrome

A

Paresthesia of median nerve cutaneous distribution
Decreased skin moisture
Atrophy of thenar muscles

120
Q

Tinel’s Sign

A

Pins and needles sensation when tapping on median nerve on anterior aspect of wrist

121
Q

Phalen’s test

A

Reproduce symptoms of carpal tunnel syndrome by patient flexing hands to maximum and holding position

122
Q

Structures not held down by extensor retinaculum

A

Dorsal venous arch
Basilic and cephalic veins
Cutaneous branches of radial and ulnar nerves

123
Q

Flexor creases

A
Distal and proximal wrist 
Thenar 
Proximal and distal palmar
Metacarpophalangeal
Proximal, distal and thumb interphalangeal
124
Q

Functions of palmar aponeurosis

A

Firm attachment to overlying skin- improve grip

Protects underlying tendons

125
Q

Dupuytren’s contracture

A

Shortening and hypertrophy of palmer aponeurosis

Painful nodules involving fascia (MP joint of digits 4 & 5)

More common in men over 50

Bilateral

126
Q

Brachiation

A

Motion of swinging from branch to branch in primates

127
Q

Vascular supply of hand

A

Radial and ulnar arteries
Superficial and deep palmar arches
Princeps pollicis (first digit)
Radialis Indicis artery (second digit)

128
Q

Intercarpal joint classification

A

Plane gliding

129
Q

Intermetacarpal joint classification

A

Plane gliding

130
Q

Interphalangeal joint classification

A

Ginglymus

131
Q

Skier’s thumb

A

Rupture or laxity of collateral ligaments of MP joint of digit 1
Hyperabduction

132
Q

Shoulder joint

Cavity deepened by

A

Glenoid labrum

133
Q

Nerve supply of shoulder joint

A

Axillary and suprascapular

134
Q

Ligaments of shoulder joint

A
Capsular 
Glenohumeral
Transverse humeral
Coracohumeral
Coracoacromial
Suprascapular
135
Q

Capsular ligament

A

Weak= versatility of joint

Long head of biceps Brachii passes out of inferior lateral portion

136
Q

____ and ____ can be damaged when humerus disarticulated from scapula

A

C5 and C6

137
Q

Glenohumeral joint

A

Prevents lateral rotation of humerus

Intrinsic rope

138
Q

Transverse humeral ligament

A

Spans intertubercular groove

Keeps long head of biceps in place

139
Q

Coracohumeral ligament

A

Limits lateral rotation of humerus

Extrinsic rope

140
Q

Coracoacromial ligament

A

Prevents upward displacement of head of humerus

Extrinsic wall

141
Q

Suprascapular ligament

A

Spans scapular notch

142
Q

Anterior dislocation of shoulder joint

A

Most common

@ inferior aspect of capsular ligament

Due to lateral rotation and excessive extension

143
Q

Anterior shoulder dislocation aka

A

Subcoracoid dislocation

Head of humerus below coracoid process

144
Q

Nerves injured with shoulder dislocation

A

Musculocutaneous and axillary

145
Q

Actions of biceps Brachii

A

Flexion of forearm
Prime mover of supination
Short head: adducts humerus
Long head: abducts humerus

146
Q

Crepitus

A

Cracking sound

147
Q

Biceps tendonitis

A

Irritation of tendon

Can cause crepitus

148
Q

Popeye deformity

A

Ruptured belly of long head of biceps Brachii

149
Q

Bicipital reflex tests for segmental innervation of

A

C5 and C6

150
Q

Segmental innervation of triceps

A

C7 and C8

151
Q

Main arterial supply to arm

A

Brachial artery

152
Q

Brachial artery divides into ___ and ___ at cubital fossa

A

Ulnar and radial arteries

153
Q

Pulse of brachial artery is taken at

A

Bicipital furrow

154
Q

Branches of brachial artery

A

Brachial profundus

Superior and inferior ulnar collaterals

155
Q

Brachial profundus

A

Supplies posterior aspect of arm

156
Q

Cutaneous veins of upper extremity

A
Dorsal venous arch
Cephalic vein
Basilic vein
Axillary vein
Brachial vein
Median cubital vein
157
Q

Dorsal venous arch

A

Prominent venous arch on back of hand

158
Q

Cephalic vein

A

Terminates and drains into axillary vein

159
Q

Basilic vein

A

Joins with brachial veins to form the axillary vein